Can You Test For CSS – Central Sensitivity Syndrome?

a lab icon productsIn the Healing Plan (HP) and on a previous post, I have discussed the fact that many of us with multiple sensitivity, chronic fatigue, fibromyalgia and chronic pain are probably suffering from some form of Central Sensitivity Syndrome illness. 

So, of course, I started trying to work out if we could get any clues. What could we test to see if we were too-turned up? Here’s a bit from the HP that might help – there’s more in the Plan:

What we’re looking for here are clues about what the sympathetic nervous system is up to. Is the dial turned up?

We can start by checking for neurotransmitter patterns – is the glutamate high and the serotonin, dopamine and/or noradrenaline low? Are you over-stimulated with excitatory neurotransmitters and yet don’t have enough of the inhibitory ones to offset it?  

Some researchers have suggested looking at the catecholamines  – that’s dopamine, adrenaline (epinephrine) and noradrenaline (norepinephrine) – and others say, if on an organic acids test Vanilmandelate and Homovanillate are high, the person is likely having a heightened sympathetic nervous response and the dial is up, especially if the serotonin marker 5-HIAA is low.

Happily, I have persuaded one of the labs to list the dried urine ZRT NeuroAdvanced test, which includes all of these markers including the VMA, HVA and 5-HIAA below so I reckon this could be termed our CSS test, or as close as we can get to one currently (I am taking a bow…!).

Looking at the adrenals can help too. Seeing cortisol levels on a DUTCH test might be useful. You want a clear picture whether metabolised cortisol is high or low.

In general, these are the two patterns to look for – and to get this you would need the ZRT NeuroAdvanced test and a DUTCH Adrenal Advanced preferably.

I am not an expert by any means and I am feeling my way a bit here, but this is how I might interpret the tests in terms of confirming CSS and relevant treatment; I hope it gives you some clues as to what form of treatment might be best for you. There’s a lot more detail in the Healing Plan in terms of lowering Substance P and things to watch out for in treatment:

  • If adrenaline, noradrenaline and/or dopamine are high and/or HVA and VMA are high with 5-HIAA low and metabolised cortisol is high – that is an acute stress CSS picture to me and this person definitely needs calming down before the body becomes tired out by it all. I would use the Lowering Cortisol advice and protocols in the Adrenal Plan (TGF version preferably) and the amygdala-calming techniques in the Healing Plan.
  • If adrenaline, noradrenaline and/or dopamine are high and/or HVA and VMA are high with 5-HIAA low and metabolised cortisol is low – this person likely has CSS and needs calming down sort of therapy like the Healing Plan. This is the pattern most often seen in PTSD. These people are hyper, anxious and reactive internally, but shattered.
  • If adrenaline/noradrenaline/dopamine are low and cortisol is low, the person is flat, fatigued and needs adrenal boosting as this is more an adrenal fatigue type picture. Use the Cortisol Boosting advice and protocol in the Adrenal Plan.

New ZRT Urine/Bloodspot Thyroid & Iodine Test Listed

Adrenal & Thyroid Tests

For those of you who don’t want a full blood test done, I have some good news! I have just listed the new ZRT Comprehensive Thyroid Panel including Iodine for us. It is done using new methodology that requires blood spot and dried urine samples so doesn’t need a full blood draw. It also includes an iodine status check (not loading) and one of the halides – bromine – plus selenium (essential co-factor) and arsenic ( a major contra to thyroid efficiency).

I STILL prefer to do separate tests such as the Thyroid Plus, the Iodine/Halides Loading and the Toxic & Essential Elements tests (the latter two on the Nutrients tests page here) as you get a lot more information, but this new one is a good compromise if you need it.

I’ve added it to the shop here and this is what I’ve said in the blurb:

For Thyroid

I could offer loads of different ones, but over the years I have found the Thyroid Plus gives the most effective, useable information. I like it because it looks for the usual TSH, free T4, free T3 etc, but also gives an idea of how much inactive reverse T3 you are making, shows up conversion problems that might be related to selenium or iodine deficiency (surprisingly common this latter one, see it in Nutrient Tests) and measures the two main peroxidase and thyroglobulin autoimmune antibodies. With all that info, you can make a start on seeing what is going wrong, what further investigations might be useful and how to treat effectively.

If you suspect hyperthyroid rather than hypothyroid, the Thyroid Advanced Test, is very similar to the Thyroid Plus but also includes the most common hyperthyroid (Graves) autoimmune antibody TRAb.

It measures: TSH, Free T3, Free T4, Total T4, Thyroid peroxidase antibody (TPO Ab), Thyroglobulin Antibody, Reverse T3 and T3 Uptake, plus the advanced TSH Receptor (TRAb) for hyperthyroid. You can read much more about the different thyroid antibodies here if you need that and see a sample report here. Centrifugation of this sample is not required but it must be sent the same day as the draw on Monday to Thursday only back to the UK lab.

There is also a new blood spot and dried urine thyroid test from ZRT which might make life easier for those of you who don’t want to do a full blood test. The ZRT Comprehensive Thyroid Panel has most of the usual markers I look for – although only one of the autoimmune antibodies and no Reverse T3 – but it does include thyroid elements like iodine, selenium, arsenic and bromine. It’s a new methodology – which always makes me slightly nervous! – but it should certainly give you enough info on thyroid problems and I rather liked the report they give too. You can read all about it here and see a sample report here.

Finally (for now!), I have also listed the new DI02 Deiodinase 2 Thyroid Gene Test. Some people have a fault on the gene that controls T3 delivery to the brain and these are often people who don’t do well on normal thyroxine treatment and who do much better in combination with T3. I can now check for this gene issue to help you determine effective treatment. You can read much more about it here: DI02 Deiodinase 2 Gene Test.

Simply put: if you suspect underactive thyroid, do Thyroid Plus (which I prefer) or the ZRT. If you suspect overactive thyroid, do Advanced Thyroid. From that, we can then assess whether you need further eg. iodine or halides testing to confirm hidden issues, which you can see below..

I hope it helps. We’re currently reviewing a few new tests and I’ll let you know about those shortly – the new Cyrex 12 pathogens test is just out too so watch this space!

New Thyroid TRAb, DI02 Gene and Symporter Iodine Tests

Fatigue icon  Hot on the heels of the new DUTCH adrenal test I listed a week or so ago, today I have added a couple of new thyroid tests for you, updated the Adrenal & Thyroid Tests Overview and added some info on Iodine Symporter Transport issues (ooer…).

Hyperthyroid Antibody TRAb Test

First comes the new Advanced Thyroid Test. This is very similar to the Thyroid Plus I have rated as the best for years for the sheer amount of info it gives you for the money. The Thyroid Plus includes all the same markers as this new one but the most common autoimmune antibodies for mainly hypothyroid disease. This new Advanced has three autoimmune antibodies, including the most common hyperthyroid (Graves) autoimmune antibody TRAb, which could be really useful.

It measures: TSH, Free T3, Free T4, Total T4, Thyroid peroxidase antibody (TPO Ab), Thyroglobulin Antibody, Reverse T3 and T3 Uptake, plus the advanced TSH Receptor (TRAb) for hyperthyroid.

You can read much more about the different thyroid antibodies here if you need that.

Simply put: if you suspect underactive thyroid, do Thyroid Plus. If you suspect overactive thyroid, do Advanced Thyroid. If you’re not sure and it’s all over the place, do the Advanced Thyroid.

Thyroid T3 Gene Test

Next, I have also listed the new DI02 Deiodinase 2 Thyroid Gene Test. Some people have a fault on the gene that controls T3 delivery to the brain even though results show levels in the body are fine. These are often people who don’t do well on normal thyroxine treatment and who would do much better having that in combination with T3.

I can now check for this gene issue to help you determine effective treatment. You can read much more about it here: DI02 Deiodinase 2 Gene Test.

Symporter Iodine Transport Testing

I got asked about this the other day and Christine & I looked it up (mostly Christine!).

I do quite a lot of iodine loading tests especially when the Thyroid Plus suggests there may be a problem going on with the production or conversion of active thyroid hormone in the body, which needs iodine to work. You can look for standard iodine levels, but I have found over time that an iodine  loading test gives better results and you can then correct it and retest after about 3 months. It can make a huge difference for something s easily found and correctable.

But, you can also have an iodine transport problem apparently. You can find out much more about it here: factsheet on Symporter transport testing and treatment. One of the key issues with this transport system is the presence of the other halides: bromide and fluoride, which compete and bind to the same receptors. I’ve offered the Halides Loading test too for years and now it seems it is a useful one for checking this Symporter issue too.

This is what I’ve put on the Nutrient Tests Overview anyway in the Q&A.

I have heard that I could have a Symporter transport problem with iodine. Can you test for that?

We don’t do an actual Symporter test as it is very unwieldy to do and hard to get done in the UK. However, we do know that one of the main causes of a symporter issue is high halides, so do the Halides Loading test first and, if those are high, you have your answer. If the halides are low, you’ve ruled that cause out, but there are others including genetic defects, goitrogens, some pesticides and oxidative stress, to name a few. 

You can do the Iodine Loading or Halides Loading Tests here.

Phew – that should help a bit with your thyroid issues! I’ve also updated the full Thyroid Factsheet here so do check that out too.

New DUTCH Adrenal and Hormone Tests

New DUTCH Adrenal and Hormone Tests now added to the shop by popular demand. Samples returned to UK and drop-shipped to US for you. Read more here: DUTCH Tests

New Cyrex 10-90 Food Tests

New Cyrex 10-90 food tests now on the shop for you as promised in a new section: Gluten, Cyrex and Autoimmune Tests http://ow.ly/r7g23006hyU

This Is How Functional Medicine Works

I find it incredibly difficult sometimes to explain to enquirers just how the type of approach I take to health conditions actually works! It’s really complex stuff and very individualised.

So, I was really pleased to see a Natural Medicine Journal article recently which takes three cases and shows what process each went through and what outcomes they gained. Note here this is talking about the functional medicine approach – in my view, this is another way of saying naturopathic nutritional medicine with testing, which is I what have been doing for years! That said, I think we need it expressed in this more medical format if mainstream medicine is going to start taking us more seriously.

I plan to add this article onto the site somewhere so I can direct people to something that will give them a good idea of how their case could be tackled by functional medicine approaches. These three cases are actually chronic pain issues, mostly neuropathic and shows the problem at the start, the tests done, the treatments given and the results gained. It’s quite technical, but fascinating, to me anyway!

One point I will make is that I think they have missed out some important dietary approaches before they got all complicated with what is essentially using supplements a bit like meds to effect biochemical changes. For example in two of the cases, I note the DN4 neuropathic questionnaire score didn’t change much. The patients were diagnosed as gluten free but had they gone truly gluten free (ie. grain and cross-reactives free), I am pretty certain this would have dropped a lot more.

Anyway, have a read here:

Integrative and Functional Medicine in Refractive, Chronic, Complex, Pain Syndromes

Three case reports

By Leigh Arseneau, ND, FMP

There’s always hope and a different approach…

Are You Oestrogen Dominant?

hormone womanI’ve just finished the latest factsheet for you, this time on oestrogen dominance in men and women. Here’s a flavour for you and you can continue reading the free factsheet here for more on how to test and what to do about it if you are. Hope it helps..

Oestrogen Dominance

Oestrogen dominance affects both men and women but you only really ever tend to see it discussed for women. It basically means where your oestrogen to progesterone ratio is out – the oestrogen is out of proportion.

That can be because the progesterone is too low – pretty common – and/or because the oestrogen intake from meds or the environment is too high.

Either way, too much oestrogen is not a good idea since many cancers and medical conditions are oestrogenic. Too much circulating about can be used, if you see what I mean. That might mean in endometriosis, fibroids or breast cancer, for example in women, or low libido, fertility issues, man ‘boobs’ or even prostate problems for men.

Here is a bit more info for you, taken from a factsheet written by Nutri, because it clearly gives male and female oestrogen dominance symptoms.

Oestrogen Dominance Symptoms: 

 

Men
 

✓  Difficulty putting on muscle

✓  Low libido

✓  Fatigue

✓  Headaches/migraines

✓  Foggy thinking

✓  Excess fat and redistribution of fat

✓  Breast growth (“man boobs”)

✓  Balding

✓  Reduced body hair

✓  Depression

✓  Anxiety

✓  Hypoglycemia

✓  Sleep problems

✓  Difficulty with urination,

✓  Increased frequency of urination

✓  Prostate enlargement

✓  Erectile dysfunction

✓  Fertility issues / low sperm count

 

 

Women
 

✓ Mood swings

✓ Depression

✓ Anxiety

✓ Low energy

✓ Foggy thinking

✓ Dry eyes

✓ Disrupted periods

✓ Low energy

✓ Hypoglycemia

✓ Weight gain

✓  Low libido

✓ PMS

✓  Hair loss

✓ Headaches/migraines

✓ Weak bladder control

✓ Irregular menstrual periods

✓ Sleep problems

✓  Fibroids

✓ Endometriosis

✓ Fibrocystic or painful breasts

✓  Cervical dysplasia

✓ Systemic lupus erythematosis

✓ Fertility issues

✓ Family history of breast cancer